Bupa cost-save plan ‘too risky’

The aged care royal commission has heard Bupa’s ‘save a shift’ policy could only worsen existing problems with care quality.

A Bupa “save a shift” policy direct­ing nursing homes not to replace care staff on sick leave could only worsen existing problems­ with care quality at its South Hobart nursing home, one of the company’s former executives has conceded.

But an even more radical proposa­l from Bupa’s commercial finance team to cut staff costs month-on-month until financial sustainability was reached was considered too controversial to be implemented, the executive told the aged-care royal commission in Hobart on Thursday.

Stephanie Hechenberger, a former regional manager with responsibility for at least 10 residential aged-care homes, con­ceded­ that reducing care staff at South Hobart, which had a previous history of issues surrounding its quality of care, was a misguided strategy.

Counsel assisting the commission, Peter Rozen QC, asked Ms Hechenberger if in 2017 there was a “clear directive that was being passed on to facility manager­s from the executive level … that staff members who went off sick would not be replaced as a way of saving costs.”

“It was,” she replied.

“And that could only exacerbate the problems with care and particularly clinical care that had been revealed in the audit history­ at Bupa South Hobart, couldn’t it?” Mr Rozen asked.

“Yes, that’s correct,” she said.

Bupa South Hobart is being examined by the commission as a study in determining approp­riate governance standards in residential aged care.

The nursing home was sanctioned in October last year by the Australian Aged Care Quality Agency for failing to meet 32 of 44 accreditation standards, includin­g 13 of 17 standards relating to quality of care. Nine other Bupa nursing homes were sanctioned between July last year and March this year.

Mr Rozen detailed an email to Ms Hechenberger from Daniel Thomas, in Bupa’s commercial finance team, which said in part: “If we want to save on staff costs we need to essentially cut hours month on month. In my opinion this is the only way forward, each month having fewer hours than the month before.”

Mr Rozen asked Ms Hechenberger how the South Hobart failures, detailed in four internal audits before the Aged Care Quality Agency sanction, could have occurred given Bupa’s resources­: “Why in a large organ­isation such as Bupa, with what looks like a really good clinical governance framework on paper, why didn’t it work?”

Ms Hechenberger replied: “Completion of the action plan only rectified the errors up until that time and once that intensity was taken away the teams would revert to poor practice.”